Right Ventricular Variants and Pulmonary Embolism—Association or Coincidence?

It has been stated that the interior of the right ventricle is as unique to each individual as one’s fingerprint. This statement is backed by numerous publications which demonstrates considerable variation in the number, shape and configuration of papillary muscles inside the normal right ventricle. It has also been shown that these variants may be the cause of cardiac rhythm disorders. In this case report another potential complication of such right ventricular papillary muscle variants is proposed—these muscles may be the source of pulmonary emboli. The pathogenesis may be that of local stasis around these aberrant muscular structures and/or emboli may form inside the right ventricle as a result of cardiac rhythm disorders, induced by these muscles. It is proposed that in future the role of the right ventricle as the source of pulmonary emboli will become more apparent and an important part of the diagnostic work up in cases of idiopathic pulmonary embolism.